PTSD, a debilitating mental health condition, afflicts between 5 and 23 percent of the 3 million veterans who have served since the 9/11 terrorist attacks. It costs the federal government more than $2 billion just in the first year of PTSD care for veterans, according to a 2012 Congressional Budget Office study.

Melanie Stengel Photo.

Michael Thomas, 49, of Milford served 17 years in the Navy and Navy Reserve, deployed to Afghanistan twice.

But, 17 years into the current conflicts, the link between PTSD and life consequences in this cohort of veterans is still unproven because there haven’t been longitudinal studies on it. Veterans’ advocates say this is a symptom of national indifference to the ongoing wars.

Thomas, 49, a Milford veteran with PTSD and traumatic brain injury, graduated from Yale Law School before he spent 17 years in the Navy and Navy Reserve, working in intelligence. He was deployed twice to Afghanistan, where it was routine to be banged around in Humvees while ducking explosives and to be constantly trying to save others from death and injury. At home, Thomas was angry and “drank like a fish,” he said. His first marriage dissolved.

In his second marriage, with PTSD symptoms including hypervigilance, he slept with a loaded gun under his pillow and had ammunition “all over the place.” One night his wife woke him as he screamed during a nightmare. Lost in his flashback dream, he didn’t recognize her and nearly hurt her. “Really bad things could have happened,” he said.

Thomas, who spent about seven years in cognitive behavioral therapy at the VA, is now pursuing his fifth career since he left the Navy in 2008. He recently started a waste-to-energy company.

Rand Corporation, a nonprofit policy think tank, has done dozens of research reports on veterans for the government and other entities, but hasn’t received a request to pursue the PTSD-life consequences connection in the post 9/11 cohort. “There are not many funders who prioritize that type of work,” said Terri Tanielian, a Rand expert on veterans’ mental health.

Tanielian is an author of a 2008 study on consequences of post-combat mental health. It relied mainly on data from veterans of previous eras and on civilians’ experiences and called for additional research on post 9/11 veterans, which hasn’t happened.

The Henry M. Jackson Foundation for the Advancement of Military Medicine is doing a study of the effectiveness of programs that these veterans access.

A 2017 survey of IAVA members found that mental health and suicide prevention, jobs and reform of the U.S. Department of Veterans Affairs were top concerns. The organization has referred 62 Connecticut veterans to 96 resources for help with employment, finances, education, disability claims, mental health and community involvement.

State Veterans Affairs Commissioner Thomas J. Saadi said he has seen “many veterans go on to rebuild what they’ve lost in their lives once they receive the support services they need.”

Boehm, 34, a Meriden veteran, lost out on a career as a lab technician, a job she held in the Army. She planned to continue that work after discharge, but after being raped twice in the military, she couldn’t mentally separate the Army job from the rapes. After her discharge, she lined up interviews for lab tech jobs, but couldn’t go through with them. “I started having flashbacks, crying,” she said.

After the rapes, Boehm became suicidal, drank excessively, and was angry. She was diagnosed with PTSD. Friends dropped her and family “walked on egg shells” around her, she said.

She plans to graduate from Southern Connecticut State University in May. She said her PTSD deprives her of getting high grades because of related anxiety, depression and problems concentrating. She works as a nanny and co-owns a business that makes mermaid-themed items. She hopes to pursue graduate school.

She receives individual counseling at the Rocky Hill Vet Center and last month started taking new medications.

“I’m in a better head space than I was,” she said.

Jason DeViva, a VA Connecticut Healthcare clinical psychologist, said with “effective treatment, we can remove some of the obstacles that stand in the way of veterans living the kind of life they want to live.”

But access to treatment is still a hurdle for veterans with PTSD, ranging from long waits for VA appointments to distance to receiving private care, said Hannah Sinoway, an IAVA services officer.

Murray, 44, a Bridgeport Army and National Guard veteran, faces other obstacles. He is living in VA transitional housing in Leeds, Massachusetts, after being in prison for two years.

Murray said he was convicted of violating a protective order initiated by his ex-wife and for threatening. He attributed his marital problems to PTSD caused by his exposure to death and ambushes in Afghanistan. He said sometimes he shut down and didn’t talk to his wife for weeks. He had road rage. His wife accused him of hitting her when he was having nightmares.

PTSD “ruined my life,” said Murray, who has an associate’s degree in business management from Sacred Heart University and was active in the Veterans of Foreign Wars. A longtime truck driver, he lost his commercial driver’s license and job after he was arrested.

Thomas Burke, co-founder of High Ground Veterans Advocacy and pastor of Northfield Congregational Church in Weston, said long wars and public indifference can cause veterans with PTSD to feel hopeless.

“Because our nation doesn’t take the end of the war seriously, that graduates to ‘why would my PTSD ever end?’” he said.

]]>http://c-hit.org/2018/11/08/post-9-11-veterans-suffering-from-ptsd-and-nations-indifference/feed/0Navy Sexual Assault Survivor Gets Discharge Upgradehttp://c-hit.org/2018/09/26/navy-sexual-assault-survivor-gets-discharge-upgrade/
http://c-hit.org/2018/09/26/navy-sexual-assault-survivor-gets-discharge-upgrade/#respondWed, 26 Sep 2018 12:44:11 +0000http://c-hit.org/?p=319581A Connecticut Navy veteran who was sexually assaulted while serving in Japan has been awarded an honorable discharge after she challenged the “bad paper” discharge status she had been given.

Bianca Cruz successfully defended her Navy record in an appeal to the Naval Discharge Review Board, which concluded that “she served honorably as evidenced by no punitive items in her record.” She was separated from the Navy in 2015 with a general (under honorable conditions) discharge, started the appeal process the next year and filed her appeal in November 2017. The board ruled Aug. 7 and notified her by email Sept. 17.

“I feel like it’s a nightmare coming to an end,” Cruz said. “I feel like I can give hope to other military sexual assault survivors.”

The board changed her military re-entry status from one which prohibited her from re-enlisting to one where she can re-enlist if she receives a waiver, something she said she wants to do. Her discharge upgrade entitles her to GI benefits, including $30,000 in current and retroactive housing costs while attending the University of New Haven, where she is slated to graduate in May.

Cruz, 24, of North Branford, was assaulted in 2014 while serving on a ship in Japan. She reported the assault, was transferred to South Carolina to get away from her attacker who was also a sailor, attempted suicide, and was ultimately discharged with a status of general (under honorable conditions).

She has attended UNH year-round since January 2017, working toward a bachelor of science degree in criminal justice, and she is doing an internship at the Orange Police Department.

Cruz’s experience reflected the findings of a Rand Corporation report released last week called “Sexual Assault and Sexual Harassment in the U.S. Military.” Its study of 560,000 service members focused on 2014, the year of Cruz’s assault. It found that Navy members serving on ships had the highest risk of being sexually assaulted, and cited assignments in Japan as having one of the highest risks of assault, with about 150 sexual assaults on sailors there that year.

The report also states that in many cases, military installations with high concentrations of young and junior-ranking personnel were at greatest risk of being sexually assaulted.

“It fits me to a T,” Cruz said of the report.

Cruz called the review board’s decision “life-changing,” explaining that among other things, “it opens up employment opportunities I wasn’t able to get otherwise.” She said her attempts to obtain jobs in law enforcement were thwarted by her military discharge status.

Cruz was represented in her appeal by the nonprofit Connecticut Veterans Legal Center, based in West Haven. Margaret Kuzma, its director of discharge upgrade practice, said Cruz’s upgrade is “a confirmation that what happened to her was wrong.” Kuzma said “it’s absolutely huge” for both Cruz’s dignity and life opportunities that she will likely be able to re-enter the service, use the GI bill, and “talk about her service with pride.”

The review board noted that it gave “liberal consideration” to Cruz’s PTSD and military sexual trauma. In 2014, the U.S. Department of Defense guided military review boards to give “liberal consideration” in upgrade cases involving PTSD and traumatic brain injury and in 2017, it expanded the guidance to include military sexual trauma.

“I hope stories like Bianca’s will inspire other men and women who have been twice victimized—by a sexual predator and then by the military’s mishandling of their discharge—to come forward and fight to remedy those injustices,” Kuzma said.

She said the legal center is now working on 52 discharge upgrade cases, 11 involving military sexual trauma.

According to the Pentagon, there were 6,769 reported cases of military sexual assault in the 2017 fiscal year, a 10 percent increase over the previous year and the highest since 2006, when the data started being recorded.

]]>http://c-hit.org/2018/09/26/navy-sexual-assault-survivor-gets-discharge-upgrade/feed/0Veterans’ Families Also Suffer From The Wounds Of Warhttp://c-hit.org/2018/07/11/veterans-families-also-suffer-from-the-wounds-of-war/
http://c-hit.org/2018/07/11/veterans-families-also-suffer-from-the-wounds-of-war/#respondThu, 12 Jul 2018 02:04:38 +0000http://c-hit.org/?p=284286Growing up, Mary Louise Montini, 13, has often been angry, upset and on edge, just like her father, a veteran with Post Traumatic Stress Disorder (PTSD).

Her experience isn’t unique. Children can develop their own mental illnesses as a result of their parents’ struggles with PTSD and other mental health disorders associated with their military service, professionals say. And there are few resources and programs targeted to veterans’ children, compared to children of active military.

Experts say the treatment needs of veterans’ children will continue as their parents continue to rotate through deployments to conflicts around the world, including in Iraq, Afghanistan and Syria.

A Rand Corporation report called “Bridging Gaps in Mental Health Care” states that mental health challenges in family members can manifest “soon or long after a service member transitions to veteran status.” Of 2.8 million veterans of conflicts in Iraq and Afghanistan, between 18.5 percent and 42.5 percent have mental disorders, the report said. Half of those deployed already had children at that time, it adds.

According to the report, research about veterans’ family members is sparse. There are “very few representative studies of veterans’ family members (spouses and children),” it states.

For the Montini family of Fairfield, the behavior and traumas endured by their father, Nicholas, have been evident through his 17-year-marriage to Kristina. A paralegal, he couldn’t hold jobs for long, often quitting in anger over minor issues. Finances were strained while Kristina was usually the sole financial support.

Agitated in crowds, Nicholas would have to leave a mall, for example, just as the family was enjoying a shopping trip. Anxiety, fear, guilt, depression, sleeplessness and horrifying nightmares took a toll on him and his family. His symptoms were classic PTSD, but he didn’t realize it, even though he was an Air Force veteran of the first Persian Gulf War. He finally sought help five years ago. Now 49, he is getting treatment at VA Connecticut Healthcare and has a job he loves. He is the New England military and veteran’s coordinator for Hope for Warriors, based in New York, which he said is therapeutic for him while enabling him to help others.

Carl Jordan Castro Photo.

Nicholas Montini, 49, served in the Air Force as an M60 Gunner during the first Persian Gulf War. He suffered from PTSD for years and finally sought treatment about five years ago.

“PTSD is an evil thing. It’s just awful,” Nicholas said.

For more than a year, the family has been getting family and individual counseling from a private therapist.

Both children said therapy has helped them understand their father’s PTSD. “I know how to deal with it. I understand it more. I get why it’s happening,” Mary Louise said. Peter, 11, who has attention deficit/hyperactivity disorder (ADHD), agreed. “I know a lot more about how it affects him,” he said. “The stuff that happens with Dad, I avoid it.”

Mary Louise has anxiety but has become less withdrawn and more social with the help of therapy, her mother said. She’s also the person Kristina vents to about their family’s issues because Kristina doesn’t know others who would understand.

Private therapy is the main source of mental health help for veterans’ families since health care provided by the U.S. Department of Veterans Affairs (VA) is mainly geared to veterans. Therapy can be expensive. Many providers don’t take insurance. In addition, they often aren’t acquainted with military and veterans’ culture.

The Montinis’ therapist takes insurance, but because of the cost of the co-pay, the family restricts visits to every other month, Kristina said.

The Montini family — Nicholas, Mary Louise, Peter and Kristina — has received family and individual counseling.

One such organization is the Cohen Veterans Network, founded and financed by billionaire Steven A. Cohen and headquartered in Stamford. It provides free or low-cost mental health counseling at 10 sites in the country, with a goal of expanding to 25. There are no treatment locations in Connecticut. The closest is at New York University’s Langone Health, which also offers teleconferencing counseling to Connecticut veterans and their families and to veterans who aren’t eligible for VA care.

Anthony M. Hassan, president and chief executive officer of Cohen Network, called for other philanthropists to fund programs like Cohen’s. He said it’s the only hope for meeting the needs of this population.

Hassan said that because of the lengthy wars in Iraq and Afghanistan, “one child can actually have grown up their entire life with their parent or parents impacted by war and deployment.” He said “family members can’t help but be impacted,” but added that “families are often an afterthought.”

Another resource is Give An Hour, an online state-by-state directory of licensed therapists who will donate at least one free hour of counseling to a veteran or family members. The service is anonymous and confidential. The therapists have a background in treating trauma and aren’t required to have experience treating veterans but are encouraged to participate in training about military culture, said Nancy Rice, chief operating officer.

Home Base, based in Boston, provides residential and outpatient treatment to veterans and services to families. It has served a few Connecticut veterans and family members in Boston and trained nearly a thousand Connecticut clinicians in military and veterans’ culture, according to a spokesperson.

Carl Jordan Castro Photo.

Mary Louise and Kristina say they often find themselves in the kitchen, venting and talking about each other’s day.

The history of mental health repercussions for veterans’ family members is long, advocates say.

Maria Phillips of Clinton, whose father served in World War II, said she and her siblings have mental health issues that include anxiety, depression and obsessive-compulsive disorder, which she called “collateral damage” from their father. She said he had what was then called “shell shock” with symptoms similar to what is now identified as PTSD and traumatic brain injury.

Phillips used her father’s veteran’s death benefit money to co-found Kids of America’s Heroes, which, among other things, teaches educators and community leaders in the state about issues confronting children of veterans and active service members.

Roni Avinadav, a clinical psychologist at the Cohen clinic at NYU, developed a training protocol to help parents “understand how their trauma history is affecting their lives and their children.”

“It’s clear there is a need” for more mental health services for veterans’ families, she said, adding “whatever can be done to help these families, they deserve more.”

]]>http://c-hit.org/2018/07/11/veterans-families-also-suffer-from-the-wounds-of-war/feed/0CT Army Veteran Gets Discharge Upgradehttp://c-hit.org/2018/04/02/ct-army-veteran-gets-discharge-upgrade/
http://c-hit.org/2018/04/02/ct-army-veteran-gets-discharge-upgrade/#commentsMon, 02 Apr 2018 15:05:00 +0000http://c-hit.org/?p=237315Connecticut veterans’ leader and decorated soldier Stephen Kennedy has won his eight-year battle to have his Army discharge status upgraded to honorable.

Kennedy, of Fairfield, president of the Connecticut branch of Iraq and Afghanistan Veterans of America (IAVA-CT), will continue his federal class action lawsuit on behalf of Army veterans nationwide who received less than honorable discharges for behavior later attributed to Post Traumatic Stress Disorder (PTSD).

Stephen Kennedy

Kennedy said in an interview that his Army service “was really central to my identity. I was really proud of that. To have them say it was less than honorable, to have that kind of stamp on it…has been a cloud over the memory of my service.”

“It’s hard not to really take that to heart,” he said, adding that having the upgrade “really feels great.”

The Army Discharge Review Board reversed Kennedy’s previous status called “general under honorable,” which deprived him of veterans’ education benefits and the pride and respect connected to an honorable discharge.

Kennedy, 31, served in Iraq for 13 months. In the Army, he was given leadership positions, fast-tracked to become a sergeant and honored with several awards including the Combat Infantry Badge, Army Commendation Medal and Army Achievement Medal. His discharge status was based on his going Absent Without Leave (AWOL) for his wedding and honeymoon, a behavior he later said was uncharacteristic for him and based on PTSD, which had resulted from his military service. He had become suicidal and self-destructive, cutting himself and drinking and smoking heavily.

Since he left the Army in 2009, he has received medical help for his PTSD, fathered three children, graduated from the University of Massachusetts, taken a leadership role in veterans’ affairs in Connecticut, and is pursuing a doctoral degree in biophysical chemistry at New York University.

He estimated that he lost out on about $90,000 in education grants under the federal GI bill because of his less than honorable discharge status. He said he will now try to be compensated under the GI bill.

Kennedy is a lead plaintiff in a lawsuit in U.S. District Court in Bridgeport, which is asking the court to order the Army to properly apply a Pentagon policy that was designed to facilitate discharge upgrades for veterans with PTSD. The policy directs military review boards to give “liberal consideration” to veterans whose service-connected PTSD is diagnosed after discharge.

A second plaintiff, Alicia J. Carson, a former Southington resident who now lives in Alaska, was given a status upgrade to honorable by the National Guard in March.

The suit was filed last April. The Yale Law School Veterans Legal Services Clinic is representing the plaintiffs. The clinic estimates that more than 100,000 Iraq and Afghanistan veterans received less than honorable discharges, also known as “bad paper” discharges. The suit is representing those who have discharges labeled as general under honorable and other than honorable (OTH).

Stephen Kennedy discusses his military service as U.S. Sen. Richard Blumenthal looks on last April.

Kennedy expressed hope that the court will require the discharge review board to handle discharge upgrade cases equitably. He had applied for an upgrade twice, in 2010 and 2015. His second application was denied in a 3-2 vote. He said that the successful application was exactly the same as the previous one, indicating to him an improper process.

“We didn’t add anything to what I filed originally and got a completely different result because a judge was watching,” Kennedy said. “To take the exact same case and come to a completely different outcome shows the need for everyone to get a review like this. When no one is watching, they are not doing this properly,” he said.

“I really hope that what comes out of this is that everyone gets the same kind of review,” he said.

“It shouldn’t take a small Army of lawyers, a class action lawsuit, and eight years to get the Army to follow their own rules,” he said in a statement, adding that “most veterans with PTSD are in no position to fight the Army like this, and veterans are dying while the Army drags its feet on properly handling these cases.”

Helen White, a Yale law student working on the case, said, “we’re encouraged to see justice done for Steve, but there are thousands of veterans across the country whose honorable service the Army still refuses to recognize.”

The new federal budget signed into law by President Trump last week includes a provision championed by U.S. Sen. Chris Murphy (D-Conn) for veterans with OTH discharges to receive long-term mental health care from the U.S. Department of Veterans Affairs (VA).

IAVA-CT is advocating changes on the state level, which would expand eligibility for state services for service members with OTH discharges and have PTSD, traumatic brain injury, or were victims of military sexual trauma. Such benefits would include state substance abuse treatment, transitional housing, long term care, tuition waivers at state colleges, burial assistance and property tax exemptions. The legislature’s Veterans Affairs Committee has approved the proposal, which needs a vote of the Senate and House to become law.

]]>http://c-hit.org/2018/04/02/ct-army-veteran-gets-discharge-upgrade/feed/1Veterans With ‘Bad Paper’ Discharges Now Eligible For Mental Health Serviceshttp://c-hit.org/2018/03/27/veterans-with-bad-paper-discharges-now-eligible-for-mental-health-services/
http://c-hit.org/2018/03/27/veterans-with-bad-paper-discharges-now-eligible-for-mental-health-services/#commentsTue, 27 Mar 2018 15:36:43 +0000http://c-hit.org/?p=233970A new federal law will allow hundreds of Connecticut veterans with “bad paper” discharges to be eligible for long-term mental health care for the first time, and thus reduce their suicide risk.

U.S. Sen. Christopher Murphy, D-Conn., a co-sponsor of the law, said it will “change the lives of veterans.” The legislation was included in the federal budget signed last Friday by President Trump.

The new law affects veterans with an “other than honorable (OTH)” discharge, a status increasingly given for minor offenses. The U.S. Department of Veterans Affairs usually denies benefits to veterans with OTH discharges, even though Congress stipulated in 1944 that only severe conduct that would lead to court martial and dishonorable discharges should disqualify veterans from basic VA care. Many veterans have maintained that their minor offenses were triggered by service-related mental health issues like Post Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI).

iStock Photo.

The suicide risk for veterans is 22 percent higher than that of civilians, reports the VA.

Under the new law, veterans with OTH discharges who either served in combat areas, were victims of military sexual trauma, or operated drones are eligible for VA mental health and behavioral health care. The law also requires the Armed Forces to give mental health screenings to all military members with an OTH status.

The suicide risk for veterans is 22 percent higher than of civilians, the VA reports. A VA study of veteran suicides in 2014 estimated that 49 Connecticut veterans committed suicide that year. Veterans who receive VA health care are less likely to kill themselves, according to the VA.

Murphy said the law will have an extensive reach nationally. “What we know is that there are tens of thousands of veterans who have bad paper discharges, who have been made ineligible for mental health services even though they have PTSD,” he said. “We have an epidemic of veterans’ suicide, and there is a much higher rate of suicide among veterans with PTSD and bad paper discharges.”

The center provides free legal services to mostly indigent veterans with mental health issues. “We have had hundreds of people with bad paper discharges come to us seeking help, usually because they want to access VA healthcare,” she said, adding that the appeal process is “incredibly onerous and not something we’re always able to win.”

Middleton said the new law will enable these veterans to obtain VA mental health care “without the help of a lawyer, which is how it should be.”

She cited a client who received emergency mental health care at the VA after a suicide attempt. Because he had an OTH discharge, the VA sent him a bill for tens of thousands of dollars, she said. “Imagine you have a catastrophic mental health crisis, the VA sends you a massive bill and you can’t continue to get care,” she said. This veteran is “exactly the kind of person who would have benefitted from” the new law. With her organization’s help, his fees were waived.

Other Connecticut veterans’ advocates praised the legislation, and called for additional benefits to help “bad paper” veterans lead productive lives.

Stephen Kennedy

Stephen Kennedy of Fairfield, president of the Connecticut branch of Iraq and Afghanistan Veterans of America (IAVA-CT), said the law is “a great step forward,” but added that other help, such as education benefits and housing assistance, can allow these veterans “to really complete their transition” to civilian life.

Meghan Brooks, of the Yale Law School Veterans Legal Services Clinic, agreed, saying “people with OTH discharges are still unable to access a wide variety of VA benefits.”

IAVA-CT is urging approval of a bill in the state legislature that would give state veterans’ benefits to those with OTH discharges who have PTSD, TBI, or were victims of military sexual trauma. Such benefits include: services at the Connecticut Veterans Home and Hospital in Rocky Hill such as substance abuse treatment, transitional housing and long-term care; tuition waivers at state colleges; burial assistance; and property tax exemptions. The measure has passed the Veterans Affairs Committee and needs approval from the Senate and House.

Jonathan Cohen, of the Yale Law clinic, expressed hope that the new federal law will reduce the stigma surrounding veterans with bad paper discharges, who he said “are often not regarded as true veterans.” He said if the law enables them to be “taken seriously as a population, it will likely have positive mental health effects on these veterans.”

VA Secretary David Shulkin has initiated a policy that provides emergency mental health care for veterans with OTH for 90 days, a time limit Murphy has called “arbitrary.”

]]>http://c-hit.org/2018/03/27/veterans-with-bad-paper-discharges-now-eligible-for-mental-health-services/feed/1Study: Marriage, Religious Doubts Can Raise Suicide Risk Among Veteranshttp://c-hit.org/2018/01/31/study-marriage-religious-doubts-can-raise-suicide-risk-among-veterans/
http://c-hit.org/2018/01/31/study-marriage-religious-doubts-can-raise-suicide-risk-among-veterans/#respondWed, 31 Jan 2018 14:35:47 +0000http://c-hit.org?p=208404Marriage and struggles with religion and spirituality significantly raise the suicide risk for veterans, according to a study funded by the U.S. Department of Veterans Affairs.

“Transitioning back into a domestic home environment may prove exceedingly difficult,” resulting in an increased suicide risk for veterans who are married or living with a partner, the study states.

In addition, suicide risk rises substantially for veterans undergoing strains in their religious and spiritual lives, the study shows. Such strains include beliefs expressed by veterans that they have been abandoned by God, that God doesn’t love them or is punishing them.

On the other hand, no effect on suicide risk was seen when veterans reported positive religious and spiritual connections.

iStock Photo.

The study found that women in their fifties were at highest risk of suicide.

A total of 772 post 9-11 veterans were surveyed by telephone, with more than 20 percent seen at risk of suicide after reporting that they have recently wished they were dead, have had thoughts of suicide and/or had attempted suicide.

The focus of the study was on the connection between veterans’ suicide and struggles with religion and spirituality, but a range of questions was asked.

Crystal Park, a University of Connecticut psychology professor and senior study investigator, said in light of the “really shocking” problem of veterans’ suicide, researchers were trying to identify factors that could be addressed in suicide prevention efforts. She said there has been “surprisingly little” research about religion’s link to suicide despite the fact that religion is important to many military members.

Between 2001 and 2014, suicide increased by 62.4 percent among female veterans and 29.7 percent among male veterans, according to VA statistics.

Nearly 42 percent of participants in the study were female. With the female military population increasing, “concern is rising regarding whether and how earlier understanding of suicide risk factors might be moderated by gender,” the study states.

Most recent VA statistics report 2 million women veterans, 9.4 percent of all veterans. By 2043, the VA predicts that women will be 16.3 percent of the veteran population.

The study was based at the VA in West Haven with chief investigator Rani A. Hoff, a Yale Medical School psychiatry professor and director of the VA’s Northeast Program Evaluation Center.

It found that of married veterans, women averaging age 50 were at highest risk of suicide. Park said that this could be less about age than the fact that many Reservists and National Guard members had enlisted prior to 9-11, and “never thought they would be deployed.” She said it is a “very different group from 20-year-olds who signed up after high school.”

A new research paper by the Resilience Center for Veterans and Families at Columbia University Teachers College concludes that post 9-11 veterans experience more stress while transitioning home than veterans of previous eras.

The research paper notes that transition stress is more prevalent than Post Traumatic Stress Disorder (PTSD), which receives more attention. It states that between 5 percent and 20 percent of post 9-11 veterans endure PTSD while 44 percent to 72 percent experience high stress levels from military separation and readjusting to civilian life. “Treatments and supports need to move beyond their nearly exclusive focus on PTSD” to also address transition stress, the study states. “Soldiers and veterans are undeniably resilient,” it states, but adds that “they’re not superhuman.”

Park, of UConn, agreed. “When you’re talking about people being stressed to the point where they’re thinking about killing themselves, we should be paying attention to that for sure,” she said.

Female veterans marry and divorce more than civilian women. As of 2015, 84 percent of women veterans were married, divorced, widowed or separated compared to 72 percent of civilian women, according to VA statistics. Some 23.4 percent of women veterans are divorced compared to 12.6 percent of civilian women, the statistics show.

The VA study estimates that 20 veterans commit suicide every day, representing 18 percent of suicides in the country.

It calls the link between religion and suicidal behavior “a novel and promising avenue for mitigating suicide risk in veterans.” Park suggested that veterans with spiritual struggles could be helped if they discuss those problems with clergy or secular therapists. However, she said “a lot of therapists aren’t comfortable dealing with religious issues.”

She pointed out that the study didn’t delve into reasons for veterans’ spiritual strains. “It suggests a deeper look” through research, she said. She speculated that it could be associated with “moral injuries people come back with” after doing or seeing things in combat that violate their sense of morality.

Park said she was surprised that the study found that positive religious and spiritual behavior had no effect on suicide risk. Such positive experience was defined in the study as: feeling part of a larger spiritual force, which could include atheism and agnosticism; considering God as a partner; and looking to God for strength, support and guidance.

“It was a little disappointing in the sense that it is not providing any particular help or advantage to people,” Park said.

]]>http://c-hit.org/2018/01/31/study-marriage-religious-doubts-can-raise-suicide-risk-among-veterans/feed/0Study: Integrating Legal Aid With Medical Care Improves Veterans’ Liveshttp://c-hit.org/2017/12/05/study-integrating-legal-aid-with-medical-care-improves-veterans-lives/
http://c-hit.org/2017/12/05/study-integrating-legal-aid-with-medical-care-improves-veterans-lives/#respondTue, 05 Dec 2017 14:01:00 +0000http://c-hit.org?p=191629Veterans’ mental health and housing improved when they accessed free legal services in a Veterans Affairs facility, according to a study of veterans in Connecticut and New York City.

The more legal services they had, the better they fared, experiencing reduced symptoms of Post-Traumatic Stress Disorder (PTSD) and psychosis, spending less money on abused substances and having better housing situations, the study found. In addition, the study concluded that mental health was improved even if veterans lost their legal battles.

The study analyzed the legal/medical partnerships between the nonprofit Connecticut Veterans Legal Center (CVLC) and VA Connecticut Healthcare and between New York Legal Assistance and two VA hospitals. It looked at free legal help given to 950 veterans from 2014 through 2016 and its effects on the mental health, housing, and income of 148 of those veterans followed closely for a year. Income improved from VA benefits, but not from employment, the study reports.

“We are really thrilled,” said Margaret Middleton, executive director of the CVLC. She said the study confirms “an anecdotal sense that we are providing real relief for our clients.”

Desirea Still Photo.

Jack Tsai, an associate professor of psychiatry and researcher with Margaret Middleton, head of CVLC.

The veterans’ most prevalent legal needs related to: VA benefits; housing, such as evictions; family issues, such as child support and divorce; and consumer problems, including credit card debt.

Sidley Cousins, 38, a Navy veteran with bipolar disorder, said his mental health improved after getting free legal help and that he is planning to be married. Cousins, who works in security in East Hartford, said the Connecticut Veterans Legal Center helped him obtain a divorce, VA disability benefits and a settlement after his car was stolen. “They helped me tremendously,” said Cousins, of New Britain, who served from 2000 through 2004.

Nationally, there are 15 medical/legal partnerships between the VA and legal services organizations, according to the study by lead author Jack Tsai, an associate professor of psychiatry at the Yale School of Medicine and a core investigator for Veterans Affairs, New England. The study was published in Health Affairs on Monday. There are 168 VA medical centers and 1,053 VA outpatient clinics nationwide.

The study shows a need for more partnerships and for proposed federal legislation that would provide funding toward legal services given at VA facilities, said Middleton, whose legal center is based at the VA Errera Center in West Haven. Her organization helps veterans who have faced homelessness and mental illness with legal problems related to health care, housing, and income.

U.S. Sen. Richard Blumenthal, D-Conn., a co-sponsor of a bill to provide funding for VA legal services, said that “access to expert legal services within the VA could mean the difference between a safe, stable home and homelessness.” He called the fact that 1 in 10 veterans is homeless, “a searing, staggering national failure.”

The VA has issued guidance to its medical centers on working with community legal providers, but it has put “little focus on civil legal problems that can affect health and impede recovery,” the study states, adding that in surveys, veterans consistently report legal help among their top unmet needs.

The study suggests a potential savings in medical care and housing services for veterans when they access legal services, but didn’t do an analysis on it. However, it states that the two legal organizations estimated the average cost of each resolved legal issue ranged from $207 to $405. The study calls this “a small amount relative to the average annual direct costs of $10,000 to $60,000 to provide care to a person who is chronically homeless, has a severe mental illness, or both.”

Meanwhile, she said the finding that mental health improved even when a case is lost was “unanticipated.” She said it means that “the very fact that you have a lawyer talk to you about your legal issue or have someone work with you on it, may have value.”

Of the 705 Connecticut veterans included in the study, most were single or divorced, white males earning less than $21,000 annually. Twenty percent served in Iraq or Afghanistan.

Middleton said the study, funded by the Bristol-Myers Squibb Foundation, is “really a starting point for trying to understand how integrating legal services into medical care works, what the mechanism is for how people’s health may improve, and how we can best provide those services to make them the most effective.”

]]>http://c-hit.org/2017/12/05/study-integrating-legal-aid-with-medical-care-improves-veterans-lives/feed/0VA Steps Up Efforts To Help Veterans Fighting Opioid Addictionhttp://c-hit.org/2017/09/25/va-steps-up-efforts-to-help-veterans-fighting-opioid-addiction/
http://c-hit.org/2017/09/25/va-steps-up-efforts-to-help-veterans-fighting-opioid-addiction/#commentsMon, 25 Sep 2017 09:54:15 +0000http://c-hit.org?p=169376Last winter, a veteran was revived with Narcan after he overdosed on heroin and collapsed just outside the doors of the VA hospital in West Haven. In 2016, another veteran at the West Haven facility was not so lucky. He died of an overdose in a public restroom.

To battle this growing scourge, Connecticut’s VA Healthcare has implemented initiatives to care for more than 1,000 veterans addicted to opioids and the federal government has awarded Yale University School of Medicine $9.7 million to research nondrug treatment for pain in veterans and military personnel, and provide national leadership in the effort.

CT VA Photo.

Lieutenant Richard Lucuk is one of 34 VA police officers now trained to administer naloxone.

Nationally, veterans using VA health care have twice the risk of opioid drug overdoses than the general public, according to the U.S. Department of Veterans Affairs.

Maria E. Niculete, a clinical psychologist at the Connecticut VA, said many veterans have been prescribed opiates for pain from service-related injuries.

“There was a significant increase in prescription opioids from 2004 through 2012 as veterans started returning home from post 9/11 deployments and sought treatment for chronic pain,” Niculete said.

In the last year, VAs nationally treated nearly 68,000 veterans for opioid addiction, a spokesperson said. In Connecticut, 1,002 veterans were treated for opioid addiction from April 1, 2016, through March 30, 2017, according to the VA in Washington.

In August, the Connecticut VA gave kits of nasal spray naloxone, which reverses overdoses and has a brand name of Narcan, to about 200 nonmedical staff including social workers who counsel veterans in their homes, soup kitchens and homeless shelters; VA police; and veterans who mentor other veterans. That’s in addition to more than 800 nasal spray kits handed out to veterans since January 2015.

Lindsay Buxbaum, a VA social work supervisor, said it was frustrating that veterans had kits, but social workers making visits weren’t authorized to use them. “It’s not a great feeling,” she said, adding that many of their clients are opiate dependent or recovering from dependence and some have died of overdoses. “Unfortunately, people do relapse. For us to be able to have this tool to help save people’s lives, we’re all really excited to be able to carry it,” she said.

A VA police officer, Lieutenant Richard Lucuk, said the veteran who was revived after overdosing close to the emergency room might have died if he had been elsewhere on VA property. But, now, he said, with the 34 VA police officers able to administer the nasal spray in parking lots and VA buildings where there is “no medical staff on hand,” lives can be saved.

Army veteran Lonnie Groom, 61, of New Haven, survived two overdoses because of naloxone. Now, after 45 years of “off and on” drug use, he’s been sober for more than a year and has received a naloxone kit from the VA.

“I still know people” with drug addictions, Groom said. “If I can help them, I’d be more than happy to do so. I see myself in them because I used to be like them,” he said.

Dr. Brian Fuehrlein.

Dr. Brian Fuehrlein, director of the Connecticut VA psychiatric emergency department, said it could take as little as six months for a prescription drug addiction to become a heroin addiction. He said most heroin users he treats are in their 20s and 30s and started using drugs with prescription opioids, either obtained legally for pain from service-related injuries or illegally to get high.

He said his department—one of four VA psychiatric emergency departments nationally—has a “novel” comprehensive approach. Its doctors are all licensed to prescribe buprenorphine, which reduces opioid cravings. Patients are sent to VA follow-up treatment, such as a five-hour-a-day program and buprenorphine clinics in West Haven and Newington, and are referred to Narcotics Anonymous.

The VA has been decreasing opioid prescriptions, particularly for chronic pain. Nationally, veterans given opioid prescriptions at VAs dropped 33 percent from 657,376 in July 2012 to 457,643 in March 2017. At the Connecticut VA, 16.5 percent fewer veterans were prescribed opioids, from 7,443 in 2012 to 6,214 in 2016, according to statistics obtained through a Freedom of Information Act request.

The Yale researchers studying nondrug pain management have CT VA ties. Dr. Robert Kerns, former director of the VA Pain Management Research Center, will head a national resource center for clinical trials on nondrug pain management. Dr. Alicia Heapy, associate director of the Pain Research Center, will test cognitive behavioral therapy for chronic pain using interactive voice response. Dr. Marc Rosen, VA director of addiction recovery services, and Dr. Steve Martino, VA chief of psychology, will study effectiveness of screening, brief intervention, and treatment referral. Their work will be part of an $81 million, federally funded research project.

Some 50 percent of veterans and 45 percent of service members endure pain regularly, according to studies.

“Many of us believe if we offer patients other methods of managing their pain, it might reduce their reliance on opioids,” Edmond said.

]]>http://c-hit.org/2017/09/25/va-steps-up-efforts-to-help-veterans-fighting-opioid-addiction/feed/2Deported Army Veteran Gains U.S. Citizenship, Reunited With Familyhttp://c-hit.org/2017/07/24/deported-army-veteran-gains-u-s-citizenship-reunited-with-family/
http://c-hit.org/2017/07/24/deported-army-veteran-gains-u-s-citizenship-reunited-with-family/#respondMon, 24 Jul 2017 19:08:46 +0000http://c-hit.org?p=149925Arnold Giammarco, the Army and National Guard veteran deported to Italy nearly five years ago, is back home in Connecticut with his wife and daughter.

On May 14, 2011, federal immigration officials stormed Giammarco’s porch as he talked on the phone, ordered him to lie face down, handcuffed him and placed him in detention. The action was long after he had served time, many years earlier, for two 1997 larceny convictions and a 2004 drug conviction. He was detained without bond for 18 months, and sent to Italy on Nov. 26, 2012.

“We’ve been blessed,” Giammarco said of his return home. “It’s a dream come true.”

Tony Bacewicz Photo

Blair Giammarco, 8, and Sharon Giammarco show the welcome banner they made for Arnold’s homecoming.

Giammarco, 61, served in the U.S. Army and the National Guard as a noncitizen soldier and received honorable discharges. His family left Italy when he was 4 years old and moved to Hartford, where he was raised. He worked mainly as a meat cutter.

His life spiraled downward when he became addicted to drugs. He stole to support his habit and was homeless. After his then-girlfriend, also a drug user, became pregnant, the pair resolved to change their lives. They quit drugs, participated in rehabilitation programs, married, got jobs and made a home for their daughter, Blair, now 8.

C-HIT reported in November 2013 that Giammarco was among a growing number of noncitizen military veterans who were deported for crimes for which they had served time years earlier.

Giammarco landed at JFK Airport on July 16, nine days after he becoming a naturalized U.S. citizen in a military ceremony at the U.S. Embassy in Rome. Giammarco had originally applied for citizenship in 1982 and said the government never processed it. Officials later contended that the application was incomplete.

Giammarco has been living in Campo Di Fano, Italy, his birthplace. He did some caretaking, attended church, helped residents with chores and continued to apply for visas and battle to return to the U.S. Being away from his wife, Sharon, and their daughter was “very disturbing, very upsetting, very traumatic, just a bad experience.”

“It’s heartbreaking” missing birthdays, holidays and everyday life with family, he said.

He credited his homecoming to his wife’s persistence and the Yale Law School clinics that have been working for his return since 2013. They initiated court actions, sought temporary visas, tried unconventional tactics — like attempting to get approval for him to testify before the state legislature — and spent months schooling him via Skype in civics questions in preparation for the citizenship interview. Two Yale students and a faculty member accompanied him to the U.S. Embassy in Rome. “They’ve been doing an excellent job,” Giammarco said, adding, “they brought everything to the table.”

In March, Giammarco’s Yale lawyers, who represented him for free, reached a settlement in a federal court suit that permitted him to submit a new naturalization application and stipulated that the “aggravated felony” for stealing tools, which had been cited by the officers who took him away, would not bar him from obtaining his citizenship. The settlement wasn’t disclosed until after Giammarco returned home.

Giammarco said he felt betrayed by the U.S. government, especially since he served in the military for six years. “I served my country. I served it honorably,” he said.

Tony Bacewicz Photo.

Sharon and Arnold Giammarco hug in their living room in Rocky Hill.

He said he never hurt anyone when he stole to support his drug habit, and he maintained that the government should have taken into account that he had reformed and had been punished for his crimes. He said he believes that immigration officials see people as “numbers” and don’t take their life circumstances into account.

“I changed my life around,” he said. “I never hurt anybody. The only ones I hurt were my wife and daughter, being away from them for so long,” he said as he sat with his wife at their dining room table.

Sharon Giammarco pointed out that she had the same drug and criminal background as her husband, but because she is a citizen, she was able to “restart my life.” She is now an addiction counselor at Blue Hills Hospital in Hartford, working 60 to 70 hours a week.

“He was punished over and over again,” she said of her husband. “I never volunteered to serve my country” as he did.

Now, Arnold Giammarco said, “all we want is a normal family.” He hopes to get a job as a meat cutter. He is spending time with his mother, Elena, 88, who receives hospice care at her Wethersfield home. Because of her health, Giammarco received an “emergency passport,” which was processed quickly. She spent “tens of thousands of dollars” in legal fees to try to get her son back to the U.S. before the Yale clinics took the case, Sharon Giammarco said of her mother-in-law.

Giammarco said he wants to make up for the years lost with his daughter. While he was in Italy, the two had communicated by Skype, and he had tried to do fatherly things like helping with her homework.

The family went camping in Bozrah with relatives last weekend. He is teaching Blair how to swim. They play ball. He made s’mores for her. “It’s cool,” Blair said of her father’s return.

His wife reminded him that being home entails other duties as well, he said with a laugh.

“She showed me where the garbage is and where the broom is,” he said.

]]>http://c-hit.org/2017/07/24/deported-army-veteran-gains-u-s-citizenship-reunited-with-family/feed/0Veterans Discharged For Misconduct Often Suffer From Mental Health Illnesseshttp://c-hit.org/2017/05/17/veterans-discharged-for-misconduct-often-suffer-from-mental-health-illnesses/
http://c-hit.org/2017/05/17/veterans-discharged-for-misconduct-often-suffer-from-mental-health-illnesses/#respondWed, 17 May 2017 13:50:36 +0000http://c-hit.org?p=130407A federal report has found that 62 percent of military personnel discharged for misconduct from 2011 through 2015 had been diagnosed with mental illnesses that could have caused their behaviors.

The Government Accountability Office (GAO) report concluded that the military failed to follow policies designed to prevent inappropriate discharge of service members with Post Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI). The result is many veterans received less than honorable discharges, making them ineligible for health care, disability benefits, or education aid from the U.S. Department of Veterans Affairs (VA).

The GAO said 57,141 service members discharged for misconduct had been diagnosed up to two years before their release with conditions that included: PTSD, TBI, adjustment disorders, alcohol-related and substance abuse disorders, depression and anxiety.

The conditions, which the GAO called “signature wounds” of the Afghanistan and Iraq wars, can affect moods, thoughts and behaviors and may trigger activities such as drug use, insubordination, absence from the military without permission, and crimes, the report states.

The report found the Armed Forces violated requirements in Pentagon policies, federal law and, in the case of the Army and Marine Corps, their own policies that included: medical exams for certain service members to determine if PTSD or TBI were factors in their misconduct; training service members to identify TBI symptoms in deployment settings; explaining potential loss of VA benefits when a veteran has a choice of an administrative discharge over a court martial trial; and monitoring adherence to policies.

Stephen Kennedy, a founder of the Connecticut chapter of Iraq and Afghanistan Veterans of America, said he was “heartened to see the GAO acknowledge what many of us have known for a long time: Veterans with PTSD, TBI and other mental health issues are being hung out to dry.”

Kennedy, who lives in Fairfield, said after soldiers are discharged for actions triggered by their service-connected conditions, “they are cut off from the very benefits that would allow them to treat those symptoms and rebuild their lives in the civilian world.”

John Rowan, president of Vietnam Veterans of America, expressed similar sentiments. “It’s horrific to think of these young men and women as statistics, but that’s what they’re becoming,” he said, calling the GAO report “immensely disturbing.”

Kennedy was discharged from the Army in 2009 after he left his base without permission to attend his wedding, an action he attributed to PTSD. He received a General Under Honorable discharge, preventing him from receiving education benefits under the GI bill and from re-entering the Army. He unsuccessfully applied for a discharge upgrade and is now a plaintiff in a federal class-action lawsuit alleging that the Army is violating a Pentagon policy that requires consideration of PTSD in upgrade applications.

In a related development, the Connecticut Veterans Legal Center (CVLC) and Swords to Ploughshares of California have received a grant to hire lawyers to represent 50 veterans with less than honorable discharges who have conditions such as PTSD and TBI and are prevented from obtaining VA benefits. The grant from the New York-based Bob Woodruff Foundation will also be used to create a manual and online courses based on the 50 cases to be used by legal organizations nationwide.

VA Secretary David Shulkin has said he will establish a policy this summer to allow veterans with other than honorable discharges and in a mental health crisis to get VA care.

U.S. Sen. Christopher Murphy, a Connecticut Democrat, has proposed legislation to provide VA mental and behavioral health care to certain veterans discharged under other than honorable conditions.